The Persistence of Eugenics

From GenEthics News issue 22,

With the International Genetics Federation congress in
Beijing looming, the issue of China's eugenics law is likely to
be in the news again. A particularly sensitive issue is the
relationship between genetics and eugenics. This article takes a
look at the history of the relationship between genetics and
eugenics, and in particular at the concept and practice of
'non-directive' genetic counselling.

David King

What is eugenics?

In discussions about the ethical and social consequences of
human genetics, there is much confusion about eugenics. The
association of the subject with full-scale genocide seems to
produce an inability to think clearly on both sides of the
debate. It is true, as geneticists often complain, that the word
is sometimes used as a blunt instrument to silence those who
argue for the benefits of genetic research. On the other hand,
there is a converse tendency to avoid any discussion of the
subject. The widely-praised House of Commons Science and
Technology Committee report on human genetics, for example, does
not mention the word once. When challenged on this, Anne Campbell
MP argued that the omission was made in order to avoid provoking
'hysteria'.

The dominant tendency is to view eugenics as a purely
historical phenomenon, and to minimise its relevance to current
debates. Within the discourse of scientists, which is dominant in
Britain, eugenics is seen as causing public fear of genetics, but
this fear is generally seen by scientists and ethicists as due to
ignorance or misunderstanding. The conventional view is that the
eugenics movement of the first four decades of this century was
based on 'bad science', or misunderstandings of genetics. The
implication of this view is that now we know so much more about
genes, and have witnessed the horrific consequences of eugenics,
we will not make that mistake again.

In the conventional definition, the key aspect of eugenics is
coercion of people's reproductive choices, for social ends, which
may include 'improving the quality of the population',
'preventing suffering of future generations' or reducing
financial costs to the state. The crucial importance of coercion
is the story that after the Second World War, interference in
reproductive choice was abolished and replaced with
'non-directive' genetic counselling. (Of course, as the recent
scandals in Sweden and elsewhere have shown, this was far from
true.) Making coercion central to the definition of eugenics
suits geneticists' interests, because it allows them to make a
clear distinction between current medical genetics and eugenics.
However, examination of the history of eugenics reveals that
coercion is certainly not one of its defining characteristics.
From its very beginnings, many eugenicists, including the founder
of the eugenics movement, Francis Galton, were opposed to
coercion. As the historian of eugenics, Diane Paul, notes,
definitions of eugenics which exclude Galton can hardly be taken
seriously.

Another common supposition is that eugenics was a right-wing
movement. But as Paul and many others have pointed out, from the
end of the nineteenth century to the middle of the twentieth,
eugenics enjoyed huge popular support amongst all sections of
society. Eugenics was also supported by many socialists,
feminists and anti-feminists, militarists and pacificists, as
well, of course, as the majority of geneticists. In different
countries eugenics took different forms, from the paternalistic
social democratic eugenics of Sweden and Norway to the fascist
eugenics of Germany. At present there is a eugenics law in the
still officially communist China. Eugenics is a broad church that
can embrace many different philosophies.

Given this, it is perhaps not surprising that discussions of
eugenics that try to label some things as 'eugenic' and others as
not, tend to founder on issues of definition. It may be
impossible to produce a definition that everyone agrees with.
Nonetheless, reflection on the history and social basis of
eugenics can allow us to understand 'what it is about', and so
help to assess the threat of its resurgence.

A form of technocracy

The massive popular support for eugenic ideas, even if not,
necessarily, for official eugenics societies or laws, indicates
that eugenics was not, as many geneticists would like us to
believe, an 'aberration'. Rather, it was a movement very much in
tune with the spirit of the times. One reason for this was
precisely its foundation in science. The late nineteenth and
first half of the twentieth century was not only the period of
high modernism in the arts, but of modernism as a popular social
ideology. And modernism's dream of progress and social order is
founded upon the belief in science and technology. In fact,
modernism simply made more explicit ideas about the role of
science that had been central since the Scientific Revolution.

Since the 17th century, the key to the economic basis and
vision of Western societies has been the use of science and
technology to control nature. But as poets and romantics like
Blake and Shelley, and later sociologists such as Weber and
Foucault have noticed, parallel to the creation of new knowledge
has been a gradual process of rationalisation and increasing
control over society in the form of scientific management, or
bureaucracy. An example from the early twentieth century is
Taylorism, the attempt to apply scientific management to
industrial processes. Taylor captured something crucial to
scientific modernism when he argued that, 'In the past, the man
has been first. In the future, the System must be first.' It is
no accident that Henry Ford was a key devotee of eugenics. Harry
Laughlin, the lynchpin of the US eugenics movement, stated in the
Birmingham Mail in 1913 that, 'Eugenics is simply the application
of big business methods in human reproduction.'

The purpose of this discussion on the role of science in
modernity is to emphasise that, in our society, an important
aspect of science is to enhance control and order. In the case of
genetics, the managerial tendency is expressed through eugenics,
which, at its root, is the urge to tidy up the accidents and mess
that arise from human reproduction. What really appalls
eugenicists is that the whole business of human reproduction is
out of rational control, and is left to chance. The eugenicists
of the early twentieth century often pointed out the care we take
over the breeding of our crops and domestic animals: how can we
be so careless about human reproduction, they asked. The desire
to bring human reproduction under rational control is the common
factor underlying the many different forms of eugenics. For most
people, eugenics was a progressive and humane aspect of
modernisation.

Under particular political circumstances, eugenicists' efforts
will be targeted at particular groups: for example in the US in
the early 20th century, a major focus was demonstrating the
supposed genetic inferiority of people from Eastern and Southern
Europe, in order to restrict their immigration. Arguably,
eugenics always targets the working classes, particularly the
poor. But in its essence, eugenics is a form of technocracy, an
attempt at social management based on the knowledge of a
scientifically qualified elite.

Genetics and eugenics

What then of geneticists' claim that eugenics is merely an
abuse of genetics, or an aberration? At one level, the answer to
this question is already clear: genetics and eugenics are
inseparably linked. Some form of eugenics is an inevitable
consequence of the advance of the science of genetics, although
the popularity of overt eugenics programmes will vary according
to social and political circumstances.

It is, however, important to note the truth in geneticists'
argument that advances in the science of genetics have done much
to discredit eugenics. Mainstream eugenics in the USA and Britain
was based on the belief that abilities and personality traits
were determined by single genes, as was 'feeblemindedness'.
Socialist geneticists such as JBS Haldane and Hermann Muller
succeeded by the 1930s in demonstrating the falseness of such
ideas. However, this did not diminish their eugenic enthusiasm,
but merely led to a more moderate reformulation, shorn of its
more outrageous class and racial prejudice. Muller, later to
receive the Nobel Prize for his discoveries in genetics,
persisted into the 1950s in his eugenic efforts. Historians are
still debating the degree to which scientists influenced the
unpopularity of eugenics after the Second World War.

For our understanding of the present, what is more important
is the consequence of the discrediting of simplistic Mendelian
eugenics in the 1920s and 30s. Amongst the funders of eugenics
research in the US, such as the Rockefeller and Carnegie
Foundations, dissatisfaction with eugenics was growing, while
ideological commitment on the part of the trustees persisted.
According to Kay1, this was at least part of the impetus behind
the Rockefeller Foundation's strategic move into supporting the
development of what became known as molecular biology:
dissatisfied with the woolly science of the eugenicists, the
Foundation decided that the cause of eugenics would be better
served by applying mathematical and physical methods, in order to
make biology into a 'hard' science. It has been molecular
biology, which led, via Crick and Watson, to genetic engineering
in the 1970s. Kay suggests that the Rockefeller Foundation's
strategic investment finally paid off in the late 1980s and 90s,
with the launch of the Human Genome Project.

What this illustrates is the way that the history of eugenics
is intertwined with that of eugenics. Problems in eugenics
stimulated research in genetics, whilst developments in genetics
informed the evolution of eugenics. This is a typical pattern in
the development of any science and its practical application.

Viewed in this perspective, the popular eugenics movement of
the early twentieth century was a highly damaging false start for
eugenics. An particular set of political circumstances propelled
it prematurely into the light, with disastrous consequences for
its reputation. After the Second World War, eugenics did not
disappear: it merely went underground. In Britain, the Eugenics
Society continues to exist, and only changed its name to the
Galton Institute in the late 1980s. Key figures, such as Francis
Crick and Victor McKusick, the doyen of medical genetics, have
continued to make eugenic pronouncements, but most of the efforts
of eugenics activists have shifted to the issue of Third World
population control.

Genetic counselling

According to the received view, the key distinction between
current medical genetics and the former eugenics is in the
practice of genetic counselling. In English-speaking countries
and Northern Europe, genetic counsellors say that they aim to not
tell their clients what to decide, and to support whatever
decisions they take. This supposed non-directiveness is the
cornerstone of geneticists' argument that they are not promoting
eugenics. Of course, this ignores the social pressures which
influence people's decisions, such as negative images of
disability, lack of support for families with disabled children,
cultural factors, etc., all of which tend to produce eugenic
outcomes (see GEN 12, pp6-9). It might be argued that it is
geneticists' duty to actively counter such pressures, but to be
fair, they cannot be held directly responsible for their
existence.

The standard rationale for offering genetic testing is that it
allows parents to exercise informed reproductive choice, and not
to 'improve' the quality of the population. But how do the
attitudes and actual practice of genetic counselling measure up
to the professional ideal? The most important research in this
area was carried by the American sociologist and ethicist,
Dorothy Wertz, and her colleague, John Fletcher2,3. In 1994-5,
they conducted a survey of the attitudes and practices of nearly
3,000 geneticists and genetic counsellors in 37 countries. Taken
at a global level, their results comprehensively demolish the
idea that geneticists have abandoned their eugenic philosophies.
Wertz often titles her talks, 'Eugenics is alive and well'.

The most consistent result from Wertz and Fletcher's survey is
that only geneticists in English-speaking countries and Northern
Europe (ENE) can make any claim to non-directiveness and
abandonment of eugenic thinking. In Eastern and Southern Europe,
the Middle East, Asia and Latin America (Rest Of the World, ROW),
geneticists not only hold eugenic ideas, but see no problem in
directing their clients in accordance with those ideas. Here are
a few examples:

In response to the clearly eugenic suggestion that 'An
important goal of genetic counselling is to reduce the number of
deleterious genes in the population', 13% of UK geneticists
agreed. In E. and S. Europe this rises to an average of 50%, and
in China and India to nearly 100%.

An average of 20% of ENE geneticists feel that, given the
availability of pre-natal testing, it is not fair to society to
knowingly have a child with a serious genetic disorder. (The
survey also revealed huge discrepancies between geneticists about
what counts as 'serious'.) In the rest of the world, majorities
of geneticists supported this view, rising to nearly 100% in some
countries.

Substantial minorities of both ENE and ROW geneticists would
advise voluntary sterilisation for women with fragile-X syndrome
(mental handicap of varying severity) living in an institution.

Approximately 15% of ENE and majorities of ROW geneticists
admit that they would provide biased pre-natal counselling
(emphasising negative aspects of a condition without actually
suggesting termination) for a variety of child- and adult-onset
genetic diseases. For conditions judged more serious, nearly 30%
of US genetics professionals would provide negatively-slanted
counselling. Conversely, where the condition is viewed as less
serious, more positive counselling would be given. Wertz says
that giving clients biased information is worse than being
directive, because it does not offer the client an opportunity to
disagree with the counsellor. None of the geneticists said that
they thought that giving biased information was dishonest.

Wertz and Fletcher's research details what geneticists say
they think and do, in response to a questionnaire. Figures
derived from such answers almost certainly underestimate the
degree to which counsellors contravene their professional norms
in practice. Research by Therese Marteau and her colleagues, in
which genetic counselling sessions were videotaped, revealed a
high level of directiveness by genetic counsellors. Most
disturbingly, the level was highest when clients were from lower
socio-economic groups. The same effect was seen in Wertz's
survey.

A new eugenics?

This examination of the history of eugenics and genetics and
the current practice of genetic counselling shows that the claim
that eugenics is simply a bogeyman from the past, which we can
easily avoid, is at best naive, and at worst disingenuous.
Geneticists need to learn something of the real history of
genetics and eugenics and examine their actions and motives a
little more carefully. Eugenics is certainly alive, but what is
the chance that it will become a real threat in the future?

We cannot answer this question in the abstract, but only by
looking at the economic and social contexts within which overt
eugenics policies become attractive. The biologist and historian,
Garland Allen, has shown how the eugenics movement became popular
in the US in response to fear of chaos caused by social and
economic changes4. In the late 19th century, the US was
undergoing major industrial expansion and restructuring of its
economy, together with an influx of refugees from Europe. These
conditions created major social unrest, including strikes, which
often led to violence. Similar factors were also at work in
Germany. The response was calls for more planning and regulation
of the economy, and of society. Like Taylorism, eugenics was
appealing as a modern, progressive and purportedly
scientifically-based system for creating more order in society.

In the 1990s, we may be experiencing something similar.
Economic globalisation is eroding people's standard of living and
job security, leading to a 'New World Disorder', in which
resource shortages and environmental crisis, as well as the
emergence of new diseases, is leading to widespread fear and
uncertainty. A crucial similarity with the early part of the
century is a perceived shortage of resources for health and
welfare: the widespread current discussion of healthcare
rationing may fuel pressures to introduce genetic screening
programmes as cost-saving public health measures.

Of course the 1990s are not the 1920s and 30s, and we have
seen what eugenics and fascism can do. If there is to be a new
popular eugenics in industrialised countries, it will have to
come in disguise. On the other hand, the scientific basis of
eugenics is a lot more plausible now. The success of genetics is
also fuelling popular genetic determinist attitudes about
personality and behaviour that are very similar to those common
in the first part of this century.

At least initially, a new eugenics will most likely be a
laissez faire eugenics. The dominant concept now is consumer
choice in reproduction, an idea unheard of in the 1930s. Although
we are unlikely to see a new generation of eugenic activists
publicly arguing for such policies, the outcome will tend to be
the same. It is rather pointless to debate definitions and
whether or not we call this eugenics. The point is that the
underlying drive towards control of reproductive mess is still
very much alive, and scientific and social conditions are right
for this drive to be expressed.

The danger we will need to guard against is the development of
a kind of eugenic common sense, that it is irresponsible to
refuse to undergo tests, and that every child has the 'right' to
a healthy genetic endowment. It may soon become common sense that
sex is for fun, but having a baby is a serious matter, not to be
left to chance. We will need to be vigilant for eugenics
disguised as public health measures.

It is vital that we have an informed public debate about
eugenics and where we are going with the new genetics. The debate
must move beyond sensationalism and self-defensive posturing by
geneticists. It is equally vital that the debate begins now,
while there is still time to act.

References

1. Kay, L. 1993. The molecular vision of life: Caltech, the
Rockefeller Foundation, and the rise of the new biology New York:
Oxford University Press.